Individual
GORGE YAKOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1225 W 190TH ST STE 280, GARDENA, CA 90248-4305
(310) 515-8113
Mailing address
14541 DELANO ST, VAN NUYS, CA 91411-2820
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95063795
CA
363LF0000X
Family Nurse Practitioner
NP95022810
CA
Other
Enumeration date
10/21/2022
Last updated
02/07/2024
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